Noninvasive diffusion MRI to determine the severity of peripheral nerve injury |
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| Institution: | 1. Vanderbilt University Medical Center, Department Radiology and Radiological Sciences, Nashville, TN, United States of America;2. Vanderbilt University Medical Center, Institute of Imaging Science, Nashville, TN, United States of America;3. Vanderbilt University Medical Center, Department of Plastic Surgery, Nashville, TN, United States of America;4. Vanderbilt University Medical Center, Department of Biostatistics, Nashville, TN, USA;5. Vanderbilt University, Department of Biomedical Engineering, Nashville, TN, United States of America;6. Barrow Neurological Institute, Division of Neuroimaging Research, Phoenix, AZ, United States of America;1. Department of Electrical Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile;2. Department of Mechanical Engineering, Universidad Técnica Federico Santa María, Santiago, Chile;3. School of Biomedical Engineering, Universidad de Valparaíso, Valparaíso, Chile;4. Department of Radiology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile;5. Biomedical Imaging Centre, Pontificia Universidad Católica de Chile, Santiago, Chile;6. Millennium Nucleus for Cardiovascular Magnetic Resonance, Santiago, Chile;1. Department of Earth Sciences, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy;2. National Research Council - Institute for Complex Systems (CNR-ISC) c/o Physics Department Sapienza University of Rome, Rome, Italy;3. Consiglio Nazionale delle Ricerche - Istituto per la Microelettronica e Microsistemi (CNR-IMM) Bologna, P. Gobetti 101, 40129 Bologna, Italy;4. Consiglio Nazionale delle Ricerche - Istituto per lo Studio dei Materiali Nanostrutturati (CNR-ISMN) Bologna, P. Gobetti 101, 40129 Bologna, Italy;5. Department of Mathematical and Computational Sciences, Physics Science and Earth Sciences (MIFT), University of Messina, Messina 98166, Italy;6. Centro Fermi - Museo Storico della Fisica e Centro Studi e Ricerche Enrico Fermi, Piazza del Viminale 1, 00184 Rome, Italy;1. Department of Cardiology, Boston Children''s Hospital and Department of Pediatrics, Harvard Medical School, Boston, MA, USA;2. Department of Computer Science, Technical University of Munich, Garching, Germany;3. Philips Healthcare, Gainesville, FL, USA |
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| Abstract: | ObjectivePrimary repair of peripheral nerves is recommended following transection; however, patient management following repair is challenged by a lack of biomarkers to nerve regeneration. Previous studies have demonstrated that diffusion magnetic resonance imaging (MRI) may provide viable biomarkers of nerve regeneration in injury models; though, these methods have not been systematically evaluated in graded partial transections and repairs.MethodsEx vivo diffusion MRI was performed in fixed rat sciatic nerve samples 4 or 12 weeks following partial nerve transection and repair (25% cut = 12, 50% cut = 12 and 75% cut = 11), crush injuries (n = 12), and sham surgeries (n = 9). Behavioral testing and histologic evaluation were performed in the same animals and nerve samples for comparison.ResultsDiffusion tractography provided visual characterizations of nerve damage and recovery consistent with the expected degree of injury within each cohort. In addition, quantitative indices from diffusion MRI correlated with both histological and behavioral evaluations, the latter of indicated full recovery for sham and crush nerves and limited recovery in all partially transected/repaired nerves. Nerve recovery between 4 and 12 weeks was statistically significant in partial transections 50% and 75% depth cuts (p = 0.043 and p = 0.022) but not for 25% transections.InterpretationOur findings suggest that DTI can i) distinguish different degrees of partial nerve transection following surgical repair and ii) map spatially heterogeneous nerve recovery (e.g., due to collateral sprouting) from 4 to 12 weeks in partially transected nerves. |
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